306- Brain Trauma (Alterations)

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KristaDavis
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176128
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306- Brain Trauma (Alterations)
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2012-10-07 20:47:07
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306 Brain Trauma alterations
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Exam 3
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  1. A traumatic insult to the brain possibly producing physical, intellectual, emotional, social, and vocational changes
    Major Head (brain) Trauma

    Ex: Transportationaccidents, Falls, Sports-relatedevent, Violence
  2. Cause/Effect of Closed (Blunt-Nonmissle) Trauma
    • *Head strikes hard surface or a rapidly moving object strikes the head
    • *The dura remains intact and brain tissues are not exposed to the environment
    • *Causes focal (local) or diffuse (general) brain injuries
  3. Effects of an Open (pennetrating, missile) Trauma
    • *Injury breaks the dura and exposes the cranial contents to the environment
    • *Causes primarily focal injuries
  4. *Injury directly below the point of impact
    Coup Injury 
  5. *Injury on the pole opposite the site of impact
    Contrecoup
  6. Types of Brain Trauma
    • ˜Coup injury
    • ˜Contrecoup
    • ˜Compound fractures
    • ˜Basilar skull fracture
    • Closed (Blunt-Nonmissle)
    • Open (pennetrating, missile)
  7. The force from a Focal Brain Injury can usually cause:
    Contusions
  8. Observable brain lesion
    Focal Brain Injury
  9. Contusions Cause:
    • Extradural (epidural) hemorrhages or hematomas
    • Subdural hematomas
    • Intracerebral hematomas 
  10. Categories of a Diffuse Brain Injury
    • Mild concussion
    • Classical concussion
    • Mild, moderate, and severe diffuse axonal injuries (DAI)
  11. ˜Temporary axonal disturbance causing attention and memory deficits but no loss of consciousness
    Mild Concussion
  12. Levels/Stages to a Mild Concussion
    I: confusion, disorientation, and momentary amnesia

    II: momentary confusion and retrograde amnesia

    III: confusion with retrograde and anterograde amnesia
  13. Things that occur with a Classic Cerebral Concussion (GRADE IV)
    • *Disconnection of cerebral systems from the brain stem and reticular activating system
    • *Physiologic and neurologic dysfunction without substantial anatomic disruption
    • *Loss of consciousness (<6 hours)
    • *Anterograde and retrograde amnesia
    • *Postconcussive syndrome
  14. ˜Produces a traumatic coma lasting more than 6 hours because of axonal disruption
    Diffuse Axonal Injury
  15. ˜Traumatic injury of vertebral and neural tissues as a result of compressing, pulling, or shearing forces
    Spinal Cord Trauma
  16. How dows Spinal Cord Trauma usually occur?
    • From Vertebral Injuries
    • (ie: Simple fracture, compressed fracture, and comminuted fracture and dislocation)
  17. What are the most common locations for a Spinal Cord Injury
    • cervical (1, 2, 4-7), and
    • T1-L2 lumbar vertebrae
  18. How do the locations of the vertebrae that is usually injured in Spinal Cord Trauma relate to the injury?
    Locations reflect most mobile portions of vertebral column and the locations where the spinal cord occupies most of the vertebral canal
  19. *Normal activity of the spinal cord ceases at and below the level of injury. Sites lack continuous nervous discharges from the brain.

    *Complete loss of reflex function (skeletal, bladder, bowel, sexual function, thermal control, and autonomic control) below level of lesion
    Spinal Shock
  20. *Massive, uncompensated cardiovascular response to stimulation of the sympathetic nervous system
    *Stimulation of the sensory receptors below the level of the cord lesion
    ˜Autonomic hyperreflexia (dysreflexia)
  21. Degenerative Disorders of the Spine
    • ˜Degenerative disk disease
    • (DDD)

    ˜Low back pain

    ˜Herniated intervertebral disk
  22. Degenerative Disk Disease *DDD
    • -Spondylolysis 
    • -Spondylolisthesis
    • -Spinal stenosis
  23. Cerebralvascular Disorders
    • CVAs (Cerebravascular Accident)
    • Intracranial Aneurism
    • Subarachnoid Hemmorhage 
  24. Leading cause of Disability, 3rd leading cause of death in the US
    CVA
  25. Arterial occlusions caused by thrombi formed in arteries supplying the brain or in the intracranial vessels
    (Transient ischemic attacks (TIAs)
    Thrombotic Stroke
  26. Fragments that break from a thrombus formed outside the brain 
    Embolic Stroke
  27. Types of Intracranial Aneurisms
    • Saccular (berry) aneurysms
    • Fusiform (giant) aneurysms
  28. What happens when blood escapes from defective or injured vasculature into the subarachnoid space
    Subarachnoid Hemorrhage
  29. What are the manifestations of a Subarachnoid Hemorrhage?
    • Kernig sign
    • Brudzinski sign
  30. Infection and Inflammation of the CNS
    Meningitis
  31. Types of Meningitis
    • Bacterial meningitis
    • Aseptic (viral, nonpurulent, lymphocytic) meningitis
    • Fungal meningitis
    • Tubercular (TB) meningitis
  32. Acute febrile illness, usually of viral origin with nervous system involvement
    Encephalitis
  33. What is the most common forms of encephalitis caused by?
    Arthropod-borne viruses and herpes simplex virus
  34. Neurologic Complications of AIDs
    • ˜Human immunodeficiency-associated cognitive dysfunction
    • ˜HIV myelopathy
    • ˜HIV neuropathy
    • ˜Aseptic viral meningitis
    • ˜Opportunistic infections
    • ˜CNS neoplasms
  35. Progressive, inflammatory, demyelinating disorder of the CNS
    MS (Multiple Sclerosis)
  36. Peripheral N.S. disorders
    • ALS
    • GB (Guillain-Barre syndrome)
  37. ALS
    "Lou Gehrig disease”

    Diffusely affects upper and lower motor neurons of the cerebral cortex, brain stem, and spinal cord (corticospinal tracts and anterior roots)

    Disease leads to progressive weakness leading to respiratory failure and death

    Patient has normal intellectual and sensory function until death
  38. Guillain-Barre Syndrome
    Acquired inflammatory disease causing demyelination of the peripheral nerves with relative sparing of axons

    Acute onset, ascending motor paralysis

    Humoral and cellular immunologic reaction
  39. Neuromuscular Junction Disorders
    • MG (Myasthenia Gravis)
    • *Chronic autoimmune disease
    • *An IgG antibody is produced against acetylcholine receptors (antiacetylcholine receptor antibodies)
    • *Weakness and fatigue of muscles of the eyes and the throat causing diplopia, difficulty chewing, talking, swallowing

  40. Cranial Tumors
    • Primary intracerebral tumors (gliomas)
    • •Astrocytoma
    • •Oligodendroglioma
    • •Ependymoma

    • Primary extracerebral tumors
    • •Meningioma
    • •Nerve sheath tumors
    • •Metastatic carcinoma
  41. Spinal Cord Tumors
    Intramedullary tumors

    • Extramedullary tumors
    • •Intradural
    • •Extradural

    • Manifestations
    • •Compressive syndrome
    • •Irritative syndrome
    • •Syringomyelic syndrome

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